Brain Diseases Research Papers - Academia.edu (original) (raw)

There are frequent applications for endoscopy in neurosurgery. However, endoscopic surgery in children has peculiar characteristics and is associated with different rates of success. In this study, the authors report on their experience... more

There are frequent applications for endoscopy in neurosurgery. However, endoscopic surgery in children has peculiar characteristics and is associated with different rates of success. In this study, the authors report on their experience with 134 consecutive endoscopy procedures performed in 126 patients<18 years of age. Between April 1993 and October 2007, 134 endoscopic procedures were performed in 126 children. Indications for surgery included brain tumors in 48 children, cystic lesions in 24, aqueductal stenosis in 23, various malformations in 20, hemorrhage and infarction in 6, and isolated ventricles in 5 children. In this long-term followup study, data were analyzed with respect to clinical and radiological success rates, as well as shunt dependence both in relation to lesion origin, and to the type of endoscopic procedure performed (endoscopic third ventriculostomy [ETV], septostomy, aqueductoplasty, or cystocisternostomy). Finally, the influence of patient age on the succ...

Humans were formed when their brains changed. They gained technical skills and lost communication skills. The result was violence far in excess of all other creatures and damage has been inflicted on everything from our planet to... more

Humans were formed when their brains changed. They gained technical skills and lost communication skills. The result was violence far in excess of all other creatures and damage has been inflicted on everything from our planet to ourselves. At last, mass communication by technology may compensate for inherent inadequacy if we learn to manage ourselves. When Did It All Go Wrong? It has always been wrong. There were other hominids, Denisovans, Neandertals and so on and we did a bit of breeding with them and then killed them. Why live happily with others when you can kill them? We always kill. We kill each other, animals, plants and our planet. It's what we do. We are humans. We are very successful.

The purpose of this study was to determine the effect of acute, unilateral transverse sinus occlusion on intracranial pressure (ICP) and postoperative mortality in dogs with structural intracranial disease. Affected dogs had a single... more

The purpose of this study was to determine the effect of acute, unilateral transverse sinus occlusion on intracranial pressure (ICP) and postoperative mortality in dogs with structural intracranial disease. Affected dogs had a single transverse sinus occluded during craniectomy for intracranial mass biopsy or removal. Seven dogs with space-occupying intracranial disease in the cerebellopontine angle area. The ipsilateral transverse sinus was permanently occluded during the surgical approach to the intracranial lesion to increase surgical exposure by allowing a caudal lateral rostrotentorial craniectomy to be combined with a suboccipital craniectomy. In five dogs, intracranial pressure was monitored during surgery using a fiberoptic intracranial pressure monitoring device. Initial ICP varied among dogs, ranging from 7 to 21 mm Hg. Intracranial pressure, however, decreased in all dogs after craniectomy and durotomy (P &lt; .05). No increase in intracranial pressure occurred after transverse sinus occlusion (P = .42). All dogs survived the surgical procedure. Acute, unilateral transverse sinus occlusion during craniectomy in dogs with space-occupying intracranial lesions did not result in significant increases in ICP or intraoperative mortality. Acute, unilateral transverse sinus occlusion during craniectomy can be used to increased surgical exposure to the caudal fossa of the brain without increased risk of increasing ICP.

To determine the prognostic factors for encephalopathy with bright tree appearance (BTA) in the acute phase through retrospective case evaluation. We recruited 10 children with encephalopathy who presented with BTA and classified them... more

To determine the prognostic factors for encephalopathy with bright tree appearance (BTA) in the acute phase through retrospective case evaluation. We recruited 10 children with encephalopathy who presented with BTA and classified them into 2 groups. Six patients with evident regression and severe psychomotor developmental delay after encephalopathy were included in the severe group, while the remaining 4 patients with mild mental retardation were included in the mild group. We retrospectively analyzed their clinical symptoms, laboratory data, and magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings. Patients in the severe group developed subsequent complications such as epilepsy and severe motor impairment. Univariate analysis revealed that higher maximum lactate dehydrogenase (LDH) levels (p=0.055) were a weak predictor of poor outcome. Maximum creatinine levels were significantly higher (p<0.05) and minimal platelet counts were significantly lower...

A classification of the existing multitude of cystic lesions of the brain is proposed, which allows an understanding of their genesis and consequent therapeutic implications, as well as their diagnostic characteristics. Essentially,... more

A classification of the existing multitude of cystic lesions of the brain is proposed, which allows an understanding of their genesis and consequent therapeutic implications, as well as their diagnostic characteristics. Essentially, cerebral cystic lesions may be classified into the following categories: Cysts containing CSF-like fluid, which include ex vacuo type cysts, such as leptomeningeal cysts, and cysts following surgical resection; cysts with fluid secreting walls and CSF-like content, such as arachnoid cysts; cysts associated with dysgenesis, for example Dandy-Walker cysts. The ex vacuo cysts increase craniospinal compliance, whereas the other cysts with CSF-like content do not; they are not per se expansive, however, although their occasional location along CSF pathways may cause obstruction and hydrocephalus. Another category includes cysts with a lining of non-neural epithelium like colloid cysts, epidermoid cysts, or craniopharyngiomas. They may increase in size and cause symptoms by compression, although not at the rate of tumour-associated cysts. The cysts associated with gliomas and other tumours have a pathogenesis bearing upon blood-brain barrier impairment and formation of vasogenic oedema. Finally, one may distinguish a category of cysts with infectious origin, such as brain abscesses and hydatid cysts. The cysts with CSF-like contents may be recognised by their magnetic resonance characteristics resembling those of CSF, whereas cysts containing proteinaceous fluid are associated with blood-brain barrier impairment and consequent contrast enhancement. The cysts with a lining of non-neural epithelium exhibit diverse properties of attenuation on comput tomography (CT) and magnetic resonance imaging (MRI), depending on the nature of their cyst contents.

We describe the case of a 22-year-old male affected by NFLE reporting paroxysmal RLS-like symptoms. The patient was referred to our Sleep Center due to nocturnal paresthesias and cramps involving the left leg and leading to sleep... more

We describe the case of a 22-year-old male affected by NFLE reporting paroxysmal RLS-like symptoms. The patient was referred to our Sleep Center due to nocturnal paresthesias and cramps involving the left leg and leading to sleep fragmentation. At age 4, the patient presented with secondary generalized seizures preceded by left leg discomfort, controlled on CBZ. After successive therapy discontinuation, leg symptoms built up in frequency and duration until a secondary generalized seizure re-occurred. On CBZ prompt resumption no further GM seizures occurred albeit persistence of night-time frequent cramps and paraesthesia. Sleep EEG demonstrated asymmetric interictal sharp theta on the right posterior frontal areas, whereas brain MRI results were consistent with a Taylor type right frontal cortical dysplasia. CBZ augmentation and add on therapy with LEV led to further frequency reduction of sensory symptoms.

For diffusion-weighted magnetic resonance imaging and under circumstances where patient movement can be modeled as rigid body motion, it is shown both theoretically and experimentally that translations and rotations produce phase errors... more

For diffusion-weighted magnetic resonance imaging and under circumstances where patient movement can be modeled as rigid body motion, it is shown both theoretically and experimentally that translations and rotations produce phase errors which are zero- and first-order, respectively, in position. Whlile a navigator echo can be used to correct the imaging data for arbitrary translations, only when the diffusion gradient is applied in the phase encode direction is there sufficient information to correct for rotations around all axes, and therefore for general rigid body motion. Experiments in test objects and human brain imaging confirm theoretical predictions and demonstrate that appropriate corrections dramatically improve image quality in vivo.

Whether art therapy can be an effective rehabilitative treatment for people with brain or mental diseases (e.g., dementia, Alzheimer's disease, Parkinson's disease, autism, schizophrenia) is a long-standing and highly debated... more

Whether art therapy can be an effective rehabilitative treatment for people with brain or mental diseases (e.g., dementia, Alzheimer's disease, Parkinson's disease, autism, schizophrenia) is a long-standing and highly debated issue. On the one hand, several observational studies and anecdotal evidence enthusiastically support the effectiveness of arts-based therapy. On the other hand, few rigorous clinical investigations have been performed, and there is too little empirical evidence to allow a full assessment of the risks and benefits of this intervention. Nevertheless, there is a progressively increasing demand for the development of appropriate complementary therapies to improve the personal and social lives of patients with neurodegenerative diseases. This is because conventional medical treatments are aimed at alleviating symptoms but cannot arrest or reverse the degenerative process. Thus, as disease progresses and adverse effects emerge, patients' quality of life ...

Ecchordosis physaliphora is a rare congenital, benign, hamartomatous, retroclival mass derived from notochordal tissue that is typically located intradurally in the prepontine cistern. Ecchordosis physaliphora is usually asymptomatic. In... more

Ecchordosis physaliphora is a rare congenital, benign, hamartomatous, retroclival mass derived from notochordal tissue that is typically located intradurally in the prepontine cistern. Ecchordosis physaliphora is usually asymptomatic. In rare cases, ecchordosis physaliphora can be symptomatic due to tumor expansion and compression of the surrounding structures and extratumoral hemorrhage. To our knowledge, ecchordosis physaliphora associated with intratumoral hemorrhage and vasogenic edema has not been previously described. We present a case of 22-year-old man who presented with headache and confusion. MR imaging and CT revealed intracranial ecchordosis physaliphora associated with intratumoral hemorrhage and vasogenic edema. The neurological findings resolved completely after medical therapy.